Book contents
- Frontmatter
- Contents
- Introduction
- How to use this book
- Abbreviations
- Acknowledgements
- DRUGS: AN A–Z GUIDE
- SHORT NOTES
- Routes of administration
- Loading dose
- Drug metabolism
- Enzyme systems
- Drug excretion
- Drug tolerance
- Drug interactions
- Therapeutic drug monitoring
- Target range of concentration
- Pharmacology in the critically ill
- Cardiopulmonary resuscitation
- Drugs in advanced life support
- Management of acute major anaphylaxis
- Management of severe hyperkalaemia
- Management of malignant hyperthermia
- Sedation, analgesia and neuromuscular blockade
- A practical approach to sedation and analgesia
- Opioid Conversion table
- Management of status epilepticus
- Prevention of delirium tremens and alcohol withdrawal syndrome
- Prevention of Wernicke–Korsakoffsyndrome
- Anti-arrhythmic drugs
- Inotropes and vasopressors
- Bronchospasm
- Anti-ulcer drugs
- Immunonutrition in the ICU
- Corticosteroids
- Short synacthen test
- Bone marrow rescue following nitrous oxide
- Antioxidants
- Post-splenectomy prophylaxis
- Anti-microbial drugs
- Bacterial gram staining
- Antibiotics: sensitivities
- Renal replacement therapy
- Extracorporeal drug clearance: basic principles
- Drug doses in renal failure/renal replacement therapy
- Chemical pleurodesis of malignant pleural effusion
- APPENDICES
- DRUG INDEX
- IV COMPATIBILITY CHART
Drug metabolism
Published online by Cambridge University Press: 05 November 2014
- Frontmatter
- Contents
- Introduction
- How to use this book
- Abbreviations
- Acknowledgements
- DRUGS: AN A–Z GUIDE
- SHORT NOTES
- Routes of administration
- Loading dose
- Drug metabolism
- Enzyme systems
- Drug excretion
- Drug tolerance
- Drug interactions
- Therapeutic drug monitoring
- Target range of concentration
- Pharmacology in the critically ill
- Cardiopulmonary resuscitation
- Drugs in advanced life support
- Management of acute major anaphylaxis
- Management of severe hyperkalaemia
- Management of malignant hyperthermia
- Sedation, analgesia and neuromuscular blockade
- A practical approach to sedation and analgesia
- Opioid Conversion table
- Management of status epilepticus
- Prevention of delirium tremens and alcohol withdrawal syndrome
- Prevention of Wernicke–Korsakoffsyndrome
- Anti-arrhythmic drugs
- Inotropes and vasopressors
- Bronchospasm
- Anti-ulcer drugs
- Immunonutrition in the ICU
- Corticosteroids
- Short synacthen test
- Bone marrow rescue following nitrous oxide
- Antioxidants
- Post-splenectomy prophylaxis
- Anti-microbial drugs
- Bacterial gram staining
- Antibiotics: sensitivities
- Renal replacement therapy
- Extracorporeal drug clearance: basic principles
- Drug doses in renal failure/renal replacement therapy
- Chemical pleurodesis of malignant pleural effusion
- APPENDICES
- DRUG INDEX
- IV COMPATIBILITY CHART
Summary
Most drugs are lipid-soluble and, therefore, cannot be excreted unchanged in the urine or bile. Water-soluble drugs such as the aminoglycosides and digoxin are excreted unchanged by the kidneys. The liver is the major site of drug metabolism. The main purpose of drug metabolism is to make the drug more water-soluble so that it can be excreted. Metabolism can be divided into two types:
• Phase 1 reactions are simple chemical reactions including oxidation, reduction, hydroxylation and acetylation.
• Phase 2 reactions are conjugations with glucuronide, sulphate or glycine. Many of the reactions are catalysed by groups of enzyme systems.
- Type
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- Information
- Handbook of Drugs in Intensive CareAn A-Z Guide, pp. 247Publisher: Cambridge University PressPrint publication year: 2014